Dr. Jeff Hersh: Precautionary advice for travelers

Q: My church group is going on a mission to Guatemala. What preparations should we make?

A: Many things can be done to help ensure a travelers health and safety. See your healthcare provider (HCP) well before your planned departure date.

 Get evaluated to be sure you are in good enough health for your trip.

 Your measles-mumps-rubella (MMR), diphtheria-tetanus-pertussis (DTP), chicken pox, polio, flu and any other routine vaccinations your HCP recommends should be up to date.

 Hepatitis A can be acquired by ingesting contaminated food or water. Two doses of Hepatitis A vaccine are recommended, one on day zero and the second six to 12 months later; there is benefit even if you can only get the first shot before you leave.

 Typhoid is also acquired via ingestion of contaminated food or water. The oral vaccine only requires a booster every five years (as opposed to every two to three years for the shot vaccine) and is taken in four doses, two days between each dose.

 Hepatitis B can be transmitted by exposure to blood, contaminated needles or sexual contact. Since an injury possibly requiring treatment (e.g. blood transfusion) is possible, travelers should strongly consider getting vaccinated for hepatitis B. The series of three shots is given day zero, at one month and at six months; but even if you can only get the first two shots before you leave there is benefit.

 Travelers at high risk of an animal bite (e.g. planning to work with animals or hike in rural areas) may be advised to have rabies vaccination, a series of three shots (day zero, seven and 21 to 28). Note that other treatment after rabies exposure is still required.

 Malaria is endemic in Guatemala in areas lower than 5,000 feet. If you will be in high-risk areas, you should speak to your HCP about possibly taking malaria prophylaxis medication.

 Bring a sufficient quantity of any prescription medications, and ask your HCP to recommend over-the-counter medications, a first-aid kit and other treatments that may be useful to bring.

Avoid insect bites; many diseases can be transmitted by insects including malaria, dengue fever, Chagas disease (actually transmitted by the feces of kissing bugs and not their bite) and others.

 Use insect repellent with greater than 20 percent DEET, since this will be effective for up to several hours.